Individual provider Active NPI

Candice Justine Exely, DC, CCSP, LAT

  • Chiropractor
  • Wentzville, MO
National Provider Identifier
1275000747
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2023050816 Issued in MO
Practice address
1023 Main Plaza Dr
Wentzville, MO 63385-1170
Phone
(636) 639-8944
NPI assigned
Nov 1, 2018
Last updated
Jul 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2017002741 MO
Chiropractor 111N00000X 2023050816 MO Primary

Addresses

Primary practice location

1023 Main Plaza Dr
Wentzville, MO 63385-1170

Mailing address

33 Spangle Way Dr
O Fallon, MO 63366-5525
Phone (714) 624-9538

Other practice location 1

33 Spangle Way Dr
O Fallon, MO 63366-5525
Phone (714) 624-9538

Other names 1

  • C.J. Exely Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240222001682 MO Practitioner - Chiropractic 5597109173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5551 Winghaven Blvd
Suite 20
O Fallon, MO 63368-3618
Phone (636) 614-0401

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2023050816MOMDChiropractor
2017002741MOMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
X Chiropractic & Acupuncture LLC Chiropractor CurrentSince Jan 22, 2024 Accepting new patients

Locations

1023 Main Plaza Dr
Wentzville, MO 63385
Phone (636) 327-3333

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1541030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1275000747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 SPANGLE WAY DR",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633665525",
            "telephone_number": "714-624-9538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 MAIN PLAZA DR",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633851170",
            "telephone_number": "636-639-8944"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "33 Spangle Way Dr",
            "address_purpose": "LOCATION",
            "city": "O Fallon",
            "state": "MO",
            "postal_code": "633665525",
            "country_code": "US",
            "telephone_number": "714-624-9538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EXELY",
        "first_name": "CANDICE",
        "middle_name": "JUSTINE",
        "name_prefix": "Mrs.",
        "credential": "DC, CCSP, LAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-01",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2017002741",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2023050816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "C.J.",
            "last_name": "EXELY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wentzville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.